LOIS Associate Natalia Verde significantly reduced the liability of a high-exposure New York Workers’ Compensation claim. The Claimant alleged that she tripped while walking out of an elevator that was not level with the floor, injuring the neck, back, bilateral knees, bilateral shoulders, bilateral hands/wrists, and bilateral elbows. The claim was established for the bilateral knees. Depositions of two treating doctors and two IME doctors on causal relationship of the shoulders, elbows, wrists, neck, and back were directed. One IME conceded the neck and back, while the other IME did not find causality for the bilateral shoulders, bilateral hands/wrists, and bilateral elbows.
Verde argued that none of the doctors’ reports were inherently reliable, as the Claimant failed to disclose the full extent of her prior injuries, only disclosing a prior right shoulder injury but not injuries to the neck and back. She emphasized that one treating doctor’s opinion and the IME opinion on causality to the neck and back were based on the Claimant disclosing that she did not have any prior injuries to the neck and back. While Claimant’s counsel argued that the Claimant disclosed the prior neck and back injuries on the C-3, Verde focused on the fact that the medical reports and depositions transcripts showed that the Claimant did not disclose the prior neck or back injuries. The Law Judge disallowed the neck and back, finding that the medical reports were unreliable in light of the lack of disclosure.
Verde then also argued for a disallowance of the bilateral shoulders, elbows, and wrists, based on the lack of any medical evidence of a traumatic injury. She highlighted that the Claimant’s own treating doctor conceded during cross-examination that the physical examination findings were normal and there were no diagnostics to show for a traumatic injury. The Law Judge agreed that there was no evidence of an injury to the bilateral shoulders, elbows, and wrists, and disallowed those sites as well. The disallowance of eight (8) sites has resulted in a significant reduction in exposure of the case.
